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Predicting Recovery Paths for Spinal Cord Injury Patients

Wednesday, May 16, 2018By Richard Alexander

The most difficult aspect of a spinal cord injury is the prospect of complete and permanent paralysis. Traumatic injury to the spinal cord causes progressive loss of nerve tissue, which may spread to other areas of the spinal cord and brain. MRI images can clearly document these neurological changes.

However, the long-term impact of these types of injuries can be unpredictable. Medical professionals are often uncertain if the patient will ever regain meaningful use of his limbs, how much assistance he will need to carry out daily functions, and how long the recovery and rehabilitation period will take. Some of this ambiguity may now be eliminated according to researchers from the Spinal Cord Injury Center of the University of Zurich and the Balgrist University Hospital. The research team says that they can predict the degree of meaningful recovery in patients after examining the development of microstructural differences in the brain and spinal cord during the first two years after the spinal cord injury occurred.

The ability to predict the extent of deterioration in patients with spinal cord injuries would be an extraordinary breakthrough in this area. In its study, the research team examined 15 patients with traumatic injuries to their spinal cords and 18 healthy, non-injured adults. They were examined at 2, 6, 12, and 24-month intervals to determine the extent of degeneration in the brain and spinal cord, the loss of myelin enveloping the nerve cells, and the presence of iron in cells resulting from degeneration. They found that there was a definitive connection between the recovery profile of patients after two years and the degree of degeneration of the nerves within the first six months after the injury occurred. The findings corroborate that smaller losses in nerve tissue at the time of the injury are an indicator of more successful long-term recovery.

The research team used MRIs to track recovery progression by comparing the degeneration after the injury and the positive developments generated by therapeutic intervention. This allows medical professionals to anticipate the trajectory of recovery and to see the effects of rehabilitation and therapy. The data allows for meaningful comparisons of interventional therapy vs. natural deterioration in the brain and nerve cells. The subjects will be re-examined in five years to see if their neurological deterioration has ceased.

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